Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 09/02/2024
    TIME: 0234
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-4952
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Nevada County Sanitation
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Sewage=226 Gal(s)SEWAGENoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: The reporting party states that due to a faulty check valve on a pump tank there was a release of 226 gallons of sewage onto the dirt at the given location. The release has been stopped and contained by 0145 hours. No waterways were impacted. The reporting party will conduct the cleanup.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 12480 Lowhills Rd
b. CITY:c. COUNTY: d. ZIP:
Nevada City
Nevada County95959NORTHERN SIERRA AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
09/02/20240000 Residence Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Nevada County Environmental Health
d. ADMIN. AGENCY: Nevada County Environmental Health Departmente. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-4952 *********

Created by: Warning Center on: 09/02/2024 02:34:54 AM Last Modified by: Warning Center on: 09/02/2024 02:43:05 AM